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Tetracosactide (tetracosactrin), an analogue for corticotropin (ACTH), is used to test adrenocortical function; failure of the plasma cortisol concentration to rise after administration of tetracosactide indicates adrenocortical insufficiency.

Tetracosactrin test:Measure plasma cortisol immediately before and at exactly 30 minutes and 60 minutes after an IM/IV dose of 250 micrograms. Full test details are available via the Pathology repertoire pages on the Trust Intranet.

Growth hormone (Somatropin)

Specialist use

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Somatropin

Injection

Growth hormone is used to treat deficiency of the hormone in both children and adults. This is for specialist use only and is prescribed according to NICE guidance.

Remain vigilant for signs and symptoms of hyponatraemia associated with the use of desmopressin. These may include (in mild cases) anorexia, headache, nausea or vomiting; or (in more severe cases) coma, convulsions, confusion, muscle cramps and weakness.

The CSM advise that patients being treated for PNE are warned to avoid fluid overload and to stop desmopressin during episodes of diarrhoea and vomiting. For more information

Desmopressin is a synthetic analogue of vasopressin. It is used for a number of indications including diagnosis and treatment of vasopressin sensitive cranial diabetes insipidus, primary nocturnal enuresis (PNE) and nocturia associated with multiple sclerosis where other treatments have failed. For a full list of indications refer to the BNF.

NOTE: The nasal spray is no longer licensed for PNE due to the increased risk of hyponatraemia compared to the oral formulation.

Terlipressin is used for bleeding from oesophageal varices; it is licensed to be given for up to 72 hours. However, the NICE treatment pathway for managing variceal bleeding states "offer terlipressin to patients with suspected variceal bleeding at presentation. Stop treatment after definitive haemostasis has been achieved, or after 5 days, unless there is another indication for its use." Click here to see NICE pathway.

Antidiuretic hormone antagonists

1st line

xx

Demeclocycline

Capsules 150mg

Prescribing notes

Used for treatment of hyponatraemia associated with inappropriate secretion of anti-diuretic hormone.

On this website you will now see four icons for these resources rather than two. Please use BNF Legacy or BNF for Children Legacy as these will take you to the original format of the online publications which do not have any errors or omissions.